The research program will systematically examine medication use in the elderly using a single drug category, antihypertensive agents, as a model. The program will include two components: (10 a population-based utilization study of antihypertensive therapy, using information from a large claims database to study medication compliance and secular trends of antihypertensive prescribing in geriatric practice, and (2) a clinical trial of the outcomes of antihypertensive medication reduction to measure the hemodynamic, functional, and metabolic effects of tapering antihypertensive therapy in symptomatic older patients with well-controlled blood pressure and potentially drug-related side effects. Dr. Monane will focus on issues in medication compliance and hypertension treatment, two areas critical to the management of the elderly patient. In addition, he will prepare patient education materials on these topics in an effort to optimize medication use in the outpatient setting. The substantial research, training, and clinical resources of the Harvard Division on Aging will be committed to assure accomplishment of the goals set out in this application.